Mucinous Carcinoma of the Scrotum about a Case in Yaounde

Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.

Management about intravesical histological transformation of prostatic mucinous carcinoma after radical prostatectomy:A case report

BACKGROUND Prostatic mucinous carcinoma(MC)and prostatic signet ring cell carcinoma are two variants of prostate cancer.MC has a higher overall survival time among all variants,while signet ring cell carcinoma is associated with lower survival time relative to other carcinomas.Only a small proportion of prostatic MC may contain signet ring cells.Over the last several decades there were only 12 patients that were documented in two studies.CASE SUMMARY We report on a 64-year-old man who was diagnosed with prostatic MC after he received a robotic-assisted laparoscopic radical prostatectomy in the West China Hospital.After robotic-assisted laparoscopic radical prostatectomy,the patient underwent three successive transurethral resections of bladder tumors.Pathological examination of the first transurethral resection of bladder tumors specimen indicated that the neoplasm was prostatic MC that had metastasized to the urinary bladder.The subsequent two transurethral resections of bladder tumors indicated the presence of prostatic mucinous carcinoma with signet ring cells.CONCLUSION This case report aimed to share the management experience,raise awareness,and highlight the importance of multidisciplinary cooperation of prostatic mucinous carcinoma with signet ring cells.

Primary mucinous carcinoma of the thyroid: case report and review of the literature

Primary mucinous carcinoma of the thyroid gland which is more difficult to diagnose than common thyroid cancer is an extremely rare disease.It is a malignant tumor that can secrete mucus.A 45-year-old Chinese man came to seek medical care because he found a lump in his right side.Tomography showed that there was a space-occupying lesion on the right thyroid gland which compressed the tracheal.After the operation of total thyroidectomy and lymph node dissection in the right central area,the pathological examination showed that tumor cells existed,showing a small nest-like and cribriform distribution characteristics.There were broad fibrous tissues,a large amount of mucus around the tumur cell that had no obvious amyloid deposition.The tumor cells were positive for thyroid transcription factor-1 and paired box gene-8,while they were focally positive for thyroglobulin.Considering the histological features and immunohistochemical profile and ruling out mucinous cancers originating from other organs.The patient was diagnosed with primary mucinous carcinoma of the thyroid gland.This patient is still alive at present.Prognosis of primary mucinous carcinoma of the thyroid gland is usually poor.The best way to improve the prognosis of these patients maybe to do surgery of complete tumor+lymph node resection as soon as possible.

Rapid progression of colonic mucinous adenocarcinoma with immunosuppressive condition:A case report and review of literature

BACKGROUND Colorectal mucinous adenocarcinoma is a rare subtype of colorectal cancer and is characterized by an abundance of mucin in the tumor.In addition,the colorectal mucinous adenocarcinoma often demonstrates poor differentiation in the histology of tumor cells and poor prognosis compared with those with adenocarcinoma.Here,we present the case of a young woman with colonic mucinous adenocarcinoma showing significantly rapid progression within four months of immunosuppressant therapy for Henoch-Schonlein purpura.CASE SUMMARY Here we report a rare case of ascending colon mucinous adenocarcinoma with lymph node and liver metastases which developed and progressed rapidly within four months during the treatment of Henoch-Schonlein purpura using corticosteroids.The systemic screening examinations showed no tumors before the immunosuppressant therapy.Fortunately,the patient was successfully treated with chemotherapy.CONCLUSION While no direct evidence that the immunosuppressants accelerated the tumor development,the case presen-ta tion and review of the literature demonstrated that surveillance for malig-nancies before and during treatment with immunosuppressive agents is essential.

Clinicopathological and prognostic differences between mucinous gastric carcinoma and signet-ring cell carcinoma

Objective： To analyze the differences in clinicopathologic characteristics and prognosis between mucinous gastric carcinoma （MGC） and signet-ring cell carcinoma （SRCC）. Methods： Clinicopathologic and prognostic data of 1,637 patients with histologically confirmed MGC or SRCC who received surgical operations in the Department of Gastroenterological Surgery, Beijing Cancer Hospital between December 2004 and December 2009 were retrospectively collected and analyzed. The clinicopathological features were analyzed statistically using Z2 test. Survival was analyzed using the Kaplan- Meier method and multivariate analysis of Cox proportional hazards regression model （backward, stepwise）. Results： A total of 181 patients with gastric cancer （74 MGC, 107 SRCC） were included. MGC, when compared with SRCC, was featured by senile patients, stage III and I~, upper third stomach, large tumor size, positive lymph node metastasis, and positive lymphatic vascular invasion （P〈0.05）. The overall 5-year survival rate showed no difference between the two groups （48.8% vs. 44.8%, P〉0.05）. However, the survival rate for MGC patients was significant lower than that for SRCC patients when compared among the age 〈60 years, negative distant metastasis, and tumor localized at upper third stomach （P〈0.05）. Multivariate Cox proportional hazards models revealed that distant metastasis was a significant independent prognostic indicator in MGC group, and lymph node metastasis and distant metastasis was significant independent prognostic indicators in SRCC group. Conclusions： While compared with SRCC, MGC is associated with a more aggressive tumor biologic behavior. There is no statistically significant difference in distant metastasis, an independent prognostic indicator for both MGC and SRCC, which might be the reason for no significant difference of the overall survival rate between the patients with MGC and SRCC.

Rental Mucinous Tubular and Spindle Cell Carcinoma:Case Report

Mucinous tubular and spindle cell carcinoma(MTSCC)of the kidney is an uncommon recently recognized renal cell carcinoma.We reported A 60 year's old man who presented with right flank pain,abdominal swelling and one attack of hematuria.The intraoperative finding was a huge cystic swelling arising from the right kidney occupying almost all the abdominal cavity displacing the bowel to the left side of the abdomen.There was no ascites or evidences of metastasis.Right radical nephrectomy was done.Then the diagnosis of renal MTSCC was established.General condition of the patient was improved and one year prognosis was satisfactory.To our knowledge this is the first reported case of MTSCC in Sudan,and the outcome of treatment was satisfactory.

Invasive ductal carcinoma of the pancreas showing exophytic growth

BACKGROUND:Invasive pancreatic carcinoma generally appears as poorly defined mass reflecting the infiltrative growth.We aimed to identify the histological and immunohistochemical features in a rare case of pancreatic carcinoma showing exophytic growth. METHODS:A 67-year-old woman presented with a mass of 5.0 cm in diameter in the pancreatic head.Preoperative computed tomography revealed a well-demarcated, primarily solid mass with a central low-density area. Magnetic resonance cholangiopancreatography revealed neither encasement nor dilation of the main pancreatic duct.An incorrect preoperative diagnosis was made of solid pseudopapillary tumor of the pancreas.Elevated serum carcinoembryonic antigen(CEA)levels and abnormal FDG positron emmission tomography accumulation suggested that the tumor had malignant potential requiring a pancreatoduodenectomy. RESULTS:The head of the pancreas contained a well- circumscribed encapsulated mass of 5.0 cm in diameter, comprising 50%adenocarcinoma,with mucinous carci- noma in the center and anaplastic carcinoma at the periphery.The anaplastic carcinoma comprised pleo- morphic cells(PCs)and pleomorphic giant cells(PGCs). The PGCs phagocytozed mononuclear PCs and lymphocytes adjacent to the capsule without infiltrating the capsule itself.Immunohistochemistry revealed that the anaplastic carcinoma cells including PGCs were positive for the tumor antigen Mucin 1 and CEA but negative for vimentin. CONCLUSION:Our observations suggest anaplastic carcinoma components in the present tumor have a ductal origin and that the exophytic tumor growth is associated with the phagocytotic activity of PGCs.

Mucinous colorectal adenocarcinoma:clinical pathology and treatment options

Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer(CRC)characterized by the pres-ence of abundant extracellular mucin which accounts for at least 50%of the tumor volume.Mucinous colorectal adenocarcinoma is found in 10%-20%of CRC patients and occurs more commonly in female and younger patients.Moreover,mucinous colorectal adenocarcinoma is more frequently located in the proximal colon and diagnosed at an advanced stage.Based on its molecular context,mucinous colorectal adenocarcinoma is associated with the over-expression of mucin 2(MUC2)and mucin 5AC(MUC5AC)proteins.At the same time,it shows higher mutation rates in the fundamental genes of the RAS/MAPK and PI3K/Akt/mTOR pathways.Mucinous colorectal adenocarcinoma also shows higher rates of microsatellite instability(MSI)than non-mucinous colorectal adenocarcinoma which might correlate it with Lynch syndrome and the CpG island methylator phenotype.The prognosis of mucinous colorectal adenocarcinoma as to non-mucinous colorectal adenocarcinoma is debatable.Further,the impaired responses of mucinous colorectal adenocarcinoma to palliative or adjuvant chemotherapy warrant more studies to be performed for a specialized treatment for these patients.In this review,we discuss the molecular background and histopathol-ogy of mucinous colorectal adenocarcinoma,and provide an update on its prognosis and therapeutics from recent literatures.

Clinical and CT imaging features of mucinous tubular and spindle cell carcinoma

Background There are relatively few reports focusing on clinical and multi-slice CT （MSCT） imaging findings of mucinous tubular and spindle cell carcinoma （MTSCC）.Our study aimed to characterize the clinical and MSCT imaging features of MTSCC.Methods The imaging findings in 17 patients with MTSCC by MSCT were retrospectively studied.MSCT was undertaken to investigate tumor location,size,density,cystic or solid appearance,calcification,capsule sign,enhancement pattern,and retroperitoneal lymph node metastasis.Results Tumors （mean diameter,（3.9±1.7） cm） were solitary （17/17）,solid （16/17） with cystic components （5/17）,had no calcifications （14/17）,had a poorly defined margin （14/17）,were centered in the medulla （15/17）,compressed the renal pelvis （7/17）,and neither lymph node nor distant metastasis was found.The attenuation of MTSCC tumors was equal to that of the renal cortex or medulla on unenhanced CT （32.3±2.6,36.3±4.6,33.2±3.9,respectively,P ＞0.05）,while tumor enhancement after administration of a contrast agent was lower than that of normal renal cortex and medulla during all phases （P ＜0.05）.Conclusion MTSCC tends to be a solitary,isodense mass with poorly defined margin arising from the renal medulla with enhancement less than the cortex and medulla during all phases.

Comparison of open and closed hyperthermic intraperitoneal chemotherapy: Results from the United States hyperthermic intraperitoneal chemotherapy collaborative

BACKGROUND Cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)for peritoneal carcinomatosis can be performed in two ways:Open or closed abdominal technique.AIM To evaluate the impact of HIPEC method on post-operative and long-term survival outcomes.METHODS Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative database.Post-operative,recurrence,and overall survival outcomes were compared between those who received open vs closed HIPEC.RESULTS Of the 1812 patients undergoing curative-intent CRS and HIPEC,372(21%)patients underwent open HIPEC and 1440(79%)underwent closed HIPEC.There was no difference in re-operation or severe complications between the two groups.Closed HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d mortalities.On multi-variable analysis,closed HIPEC technique was not a significant predictor for overall survival(hazards ratio:0.75,95%confidence interval:0.51-1.10,P=0.14)or recurrence-free survival(hazards ratio:1.39,95%confidence interval:1.00-1.93,P=0.05)in the entire cohort.These findings remained consistent in the appendiceal and the colorectal subgroups.CONCLUSION In this multi-institutional analysis,the HIPEC method was not independently associated with relevant post-operative or long-term outcomes.HIPEC technique may be left to the discretion of the operating surgeon.